Robotically implemented medical procedures, commonly called robotic surgery, is in widespread use for a variety of medical interventional procedures involving many different organs of a patient. Particularly in the case of abdominal procedures, such as those involving the pancreas or the liver, the organ in question is physically moved or otherwise modified by the robotic manipulator during the course of the procedure. Such changes are designated below as geometric changes to the region or anatomy. Similar changes in the organ or the region of interest also occur at other sites within the patient.
As is well known, commercially available robotic manipulators are operated by a physician (surgeon) to execute a number of physical interactions with one or more organs during the procedure, such as grabbing, cutting, pushing, pulling, etc. It may be the case that the surgical site is resected in order to expose the organ that is being manipulated, but certain types of procedures may also be implemented with only a small incision for introducing an instrument or endoscope.
A computed tomography or magnetic resonance image of the surgical site may be obtained as part of a planning procedure. During the actual procedure, an endoscopic image may be obtained, and the content of such an endoscopic image is thus limited by the field of view of the camera that is used to obtain the endoscopic image. The endoscopic image may include only contents that are within the direct line of sight of the camera and thus only the sides of organs and surrounding tissue that are facing the camera may be seen in such an image.
Although the organ of interest in the planning image may be segmented and then rotated, translated, or otherwise changed in known ways at the display screen, the planning image, since it was obtained before the surgical procedure started, will not show changes in the organ itself, such as cutting thereof, that occur during the course of the surgical procedure, and also will not show changes in the position of the organ that may also occur during the course of the procedure.
Known robotic manipulators that are used in surgical procedures are operated from a control console, at which the surgeon is situated. The control console includes a number of manually operated or manipulated elements that the physician operates in the same manner as if the physician were using an instrument at the actual site of the surgery. Thus, for example, if the physician wants to implement a cutting procedure on the organ via the robotic manipulator, a scissors-like control element will be provided at the console. The corresponding cutter of the robotic manipulator is provided with appropriate force sensors, which detect forces at the organ that are applied by the robotic manipulator, and also detect forces on the robotic manipulator that are produced by the organ. This combination of forces provides haptic feedback to the surgeon at the console so that the surgeon operating the scissors-like control element will experience the same cutting force, and resistance of the organ to such a cutting force, that the surgeon would feel if the physician were directly manually operating a cutting element at the surgery site.
The same is true with regard to other types of instruments that are implemented by the robotic manipulator, such as instruments that grab the organ in order to allow the surgeon to then displace all or a portion of the organ in a selected manner.